We’re sharing the answers to your most common questions about self-funded healthcare benefit infrastructure and how EHN helps employers and their workforces.
Q: Who does EHN work with?
We work with businesses searching for affordable yet quality options for employee healthcare benefits. By connecting companies directly with vetted healthcare providers under a fully transparent model, we help secure better care at the right price.
Q: How do you manage members who are outside your service area?
To offer the most comprehensive service for your employees (our members), we focus the provider networks we build in the most relevant geographic regions for our customers. We also make additional network arrangements to manage members outside the service areas.
Q: How do healthcare providers benefit by being part of the EHN network?
EHN fosters a strong connection between our employer customers and healthcare provider partners. This allows for more consistent care management and promotes an ongoing relationship between the provider, the employer group and the plan participants.
Q: How are you different from traditional carriers?
We work collaboratively with employers and healthcare providers in their regions to secure quality, customized care and services for employees at an affordable price. This direct connection between businesses and providers is the key to managing healthcare offerings for employees on a long-term basis. Through our pharmacy benefit management services, we also manage prescription costs so members have affordable access to medication. The final difference between carriers and EHN is that we believe in complete data transparency; data should be used to create effective change, not as a competitive edge.
Q: What does your network look like?
The EHN healthcare provider network is regionally concentrated in South Carolina and Florida, with an extended national network for members located and traveling throughout the USA.
Q: What are the potential savings for employers with a self-funded healthcare benefit?
While we cannot predict how much a customer may save, we typically achieve an initial reduction in overall cost, and a significant moderation in the annual trend. We start with a comprehensive evaluation of your prescription spending. Using your existing information, we evaluate how our fully-transparent pharmacy benefit management programs can reduce prescription costs. From there, we use that data to better understand the conditions and geographic distribution of your employees and their families to fit our network models.
Q: How does the EHN approach differ from other employer options?
We have a proven track record of bringing employer's and their employees healthcare costs under control while providing a benefit that employees and their families can understand and appreciate.
Q: How does EHN do a better job of controlling costs?
There are several ways we help manage costs for our customers. First, our relationship with contracted medical providers is one of a partnership — we do not treat them as just a contracted entity. Thirty years of experience has taught us that an employer can only control cost by working with the local medical providers as partners. The primary issue with controlling cost is not the unit price of medicine (the "network" pricing), it is how the system is used, and employers cannot control utilization without the active support of the medical community.
Secondly, we only use vendors who are willing to fully disclose all components of their cost. This includes TPAs, PBMs, brokers and consultants, and all other involved vendors. One of the primary reasons for rapidly rising costs is that there are too many vendors making revenue far beyond the value of their services, and there are far too many vendors receiving compensation from other vendors without adequate disclosure to the employer. Vendor cost, and especially cost relative to prescription drugs, is a major cost factor for rapidly rising costs.
Finally, we only use vendors who are recognized in the market for their service excellence and their proven ability to control cost for the employer.
Q: As an employer, what else should I understand?
A major issue in the market today is that there are far too many employers who are purchasing fully insured health benefits for their employees who should consider being self-funded. This is especially true for employers who have between 250 and 1,000 employees. Unless there is a highly unusual situation, these employers can typically lower their overall cost by being self-funded.
Q: How does the EHN provider discount compare with other plans?
EHN discounts are very competitive with their major carriers. Hospitals are looking for alternate solutions and have willingly offered to help build a quality-oriented, cost-effective network. We focus not only on service-based pricing, but also on bundled payments and pay for performance, allowing healthcare providers to take more effective control of their cost and quality.